Healthcare Provider Details

I. General information

NPI: 1548663164
Provider Name (Legal Business Name): CHERYL GOLDFARB-GREENWOOD R.N., MN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL GOLDFARB R.N., MN, CNS

II. Dates (important events)

Enumeration Date: 09/28/2014
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WELCH RD STE 212
PALO ALTO CA
94304-1509
US

IV. Provider business mailing address

750 WELCH RD STE 212
PALO ALTO CA
94304-1509
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-7501
  • Fax: 650-724-6500
Mailing address:
  • Phone: 650-723-7501
  • Fax: 650-724-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number428701
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number256
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SN0000X
TaxonomyNeonatal Clinical Nurse Specialist
License Number256
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: